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. 2022 Sep 27:15:5679-5689.
doi: 10.2147/IDR.S381604. eCollection 2022.

Trends and Correlation Between Antimicrobial Resistance and Antibiotics Consumption in a Specialist Children's Hospital from 2016 to 2021

Wenting Gong #  1 , Wen Tang #  2 , Lan Luo  3 , Furong Zhang  1 , Chenyang Cai  1 , Jiangyan Zhang  1 , Xiaolin Wu  4 , Jianping Shang  4 , Xiaolan Shu  2 , Ting Wang  5 , Danna Tu  6 , Zhengjiang Jin #  7 , Ronghao Zheng #  4
Affiliations

Trends and Correlation Between Antimicrobial Resistance and Antibiotics Consumption in a Specialist Children's Hospital from 2016 to 2021

Wenting Gong et al. Infect Drug Resist. .

Abstract

Purpose: To explore the trends and correlation between antibiotics consumption and antimicrobial resistance in children in a specialist hospital from 2016-2021 in China.

Patients and methods: This retrospective study investigated data on the consumption of antibiotics and antimicrobial resistance in children. Antibiotics consumption was expressed as defined daily doses (DDDs)/1000 patient-days based on the Guidelines for Anatomical Therapeutic Chemical. The trends in antibiotics consumption and antimicrobial resistance rates were analyzed by linear regression, while Spearman correlation analysis was employed to evaluate their correlations.

Results: An increasing trend in the annual consumption of carbapenems and monobactams was detected (all P<0.05). A significant upward trend was detected in the annual resistance rates of Enterococcus faecium to ciprofloxacin, Streptococcus pneumonia to ceftriaxone, Acinetobacter baumannii to carbapenems, Enterobacter cloacae to carbapenems, Pseudomonas aeruginosa to ceftazidime, and Escherichia coli to cefepime, while the annual resistance rates of Escherichia coli to carbapenems had a significant downward trend (all P<0.05). The consumption of cephalosporin/β-lactamase inhibitor (C/BLI) combinations and carbapenems had significant positive correlations with the resistance rates of Acinetobacter baumannii to carbapenems (r=0.763, P<0.001; r=0.806, P<0.001), Enterobacter cloacae to carbapenems (r=0.675, P<0.001; r=0.417, P=0.043), and Pseudomonas aeruginosa to ceftazidime (r=0.625, P=0.001; r=0.753, P<0.001), respectively. Also, increasing consumption of monobactams was related to the upward resistance rates of Acinetobacter baumannii to carbapenems (r=0.557, P=0.005) and Enterobacter cloacae to carbapenems (r=0.507, P= 0.011).

Conclusion: This study demonstrated significant positive associations between antibiotics consumption and specific antimicrobial resistance rates. The current findings pointed out some directions to pursue in controlling the prevalence of certain resistant bacterial strains in children.

Keywords: antibiotic consumption; antimicrobial resistance; children; correlation.

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Conflict of interest statement

The authors declare there are no conflicts of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
Annual trends of certain antimicrobial resistance rates during the study period. (A) Annual trends of resistance rates of E.faecium to ciprofloxacin, (S)pneumoniae to ceftriaxone and A.baumannii to carbapenems. (B) Annual trends of resistance rates of E.cloacae to carbapenems, (P)aeruginosa to ceftazidime and E.coli to cefepime and E.coli to carbapenems.
Figure 2
Figure 2
Associations between antibiotics consumption and antimicrobial resistance rates during the study period. (A) Correlation between C/BLI combinations and A.baumannii to carbapenems, E.cloacae to carbapenems and P.aeruginosa to ceftazidime. (B) Correlation between Carbapenems and A.baumannii to carbapenems, E.cloacae to carbapenems and P.aeruginosa to ceftazidime. (C) Correlation between Monobactams and A.baumannii to carbapenems and E.cloacae to carbapenems. The DDDs are shown on the left y-axis while the resistance rates are shown on the right y-axis.
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